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Extracolonic Cancer Risk After Total Colectomy for Inflammatory Bowel Disease: A Population-based Cohort Study.

炎症性肠病全结肠切除术后结肠外癌症风险: 一项基于人群的队列研究。

  • 影响因子:5.55
  • DOI:10.1093/ecco-jcc/jjz199
  • 作者列表:"Mark-Christensen A","Erichsen R","Veres K","Laurberg S","Sørensen HT
  • 发表时间:2020-06-19
Abstract

BACKGROUND:Patients with inflammatory bowel disease are at increased risk of extracolonic cancers. Little is known regarding this risk following total colectomy [TC]. METHODS:Patients who underwent TC for inflammatory bowel disease in Denmark during 1977-2013 were identified from the Danish National Patient Registry. Incidence rates of extracolonic cancers were determined through record linkage to the Danish Cancer Registry and compared with expected incidence rates in the general population. Standardized incidence ratios [SIRs] were calculated as the observed vs expected cancer incidence. RESULTS:In total, 4430 patients (3441 with ulcerative colitis [UC]; 989 with Crohn's disease [CD]) were followed for 54,183 person-years after TC. Following their surgery, 372 patients were diagnosed with extracolonic cancer compared to 331 expected [SIR = 1.1 (95% confidence interval {CI}: 1.0-1.2)]. The risk of extracolonic cancer overall was increased among patients with CD and TC (SIR = 1.5 [95% CI: 1.2-1.8]), but not among patients with UC and TC (SIR = 1.0 [95% CI: 0.9-1.2]). Patients with UC and TC had a higher risk of intestinal extracolonic cancer (SIR = 2.0 [95% CI: 1.4-2.7]). Patients with CD and TC had a higher risk of smoking-related cancers (SIR = 1.9 [95% CI: 1.2-2.9]), intestinal extracolonic cancer (SIR = 3.1 [95% CI: 1.6-5.5]) and immune-mediated cancers (SIR = 1.5 [95% CI: 1.0-2.1]). CONCLUSION:Patients with CD and TC had a higher risk of extracolonic cancer overall compared to the general population, while patients with UC and TC did not. Site-specific cancer risk varied according to inflammatory bowel disease type.

摘要

背景: 炎症性肠病患者患结肠外癌的风险增加。关于全结肠切除术后的这种风险知之甚少 [TC]。 方法: 在丹麦 1977-2013 期间因炎症性肠病接受 TC 的患者是从丹麦国家患者登记处确定的。通过与丹麦癌症登记处的记录链接确定结肠外癌症的发病率,并与一般人群的预期发病率进行比较。标准化发病率比 [SIRs] 计算为观察到的与预期的癌症发病率。 结果: 总共有 4430 例患者 (3441 例溃疡性结肠炎 [UC]; 989 例克罗恩病 [CD]) 在 TC 后随访了 54,183 人年。手术后,372 例患者被诊断为结肠外癌,预期为 331 [sir = 1.1 (95% 置信区间 {CI}: 1.0-1.2)]。CD 和 TC 患者总体结肠外癌风险增加 (sir = 1.5 [95% CI: 1.2-1.8]),但在 UC 和 TC 患者中不存在 (sir = 1.0 [95% CI: 0.9-1.2])。UC 和 TC 患者患结肠外肠癌的风险较高 (sir = 2.0 [95% CI: 1.4-2.7])。CD 和 TC 患者发生吸烟相关癌症的风险较高 (sir = 1.9 [95% CI: 1.2-2.9]),肠结肠外癌 (sir = 3.1 [95% CI: 1.6-5.5]) 和免疫介导癌 (sir = 1.5 [95% CI: 1.0-2.1])。 结论: 与普通人群相比,CD 和 TC 患者总体上有更高的结肠外癌风险,而 UC 和 TC 患者则没有。部位特异性癌症风险因炎症性肠病类型而异。

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影响因子:3.72
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影响因子:3.72
发表时间:2020-01-21
DOI:10.1093/ibd/izz331
作者列表:["Ronchetti S","Gentili M","Ricci E","Migliorati G","Riccardi C"]

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关键词: GILZ IBD 自身免疫 炎症
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